{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:13:55Z","timestamp":1790342035005,"version":"4.1.0"},"reference-count":25,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,2,13]],"date-time":"2021-02-13T00:00:00Z","timestamp":1613174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This prospective controlled trial aimed to evaluate the skeletal effect of 3.5-years bone anchored maxillary protraction (BAMP) in growing cleft subjects with a Class III malocclusion. Subjects and Method: Nineteen cleft patients (11.4 \u00b1 0.7-years) were included from whom cone beam computed tomography (CBCT) scans were taken before the start of BAMP (T0), 1.5-years after (T1) and 3.5 y after (T2). Seventeen age- and malocclusion-matched, untreated cleft subjects with cephalograms available at T0 and T2 served as the control group. Three dimensional skeletal changes were measured qualitatively and quantitatively on CBCT scans. Two dimensional measurements were made on cephalograms. Results: Significant positive effects have been observed on the zygomaticomaxillary complex. Specifically, the A-point showed a displacement of 2.7 mm \u00b1 0.9 mm from T0 to T2 (p &lt; 0.05). A displacement of 3.8 mm \u00b1 1.2 mm was observed in the zygoma regions (p &lt; 0.05). On the cephalograms significant differences at T2 were observed between the BAMP and the control subjects in Wits, gonial angle, and overjet (p &lt; 0.05), all in favor of the treatment of Class III malocclusion. The changes taking place in the two consecutive periods (\u0394T1-T0, \u0394T2-T1) did not differ, indicating that not only were the positive results from the first 1.5-years maintained, but continuous orthopedic effects were also achieved in the following 2-years. Conclusions: In conclusion, findings from the present prospective study with a 3.5-years follow-up provide the first evidence to support BAMP as an effective and reliable treatment option for growing cleft subjects with mild to moderate Class III malocclusion up to 15-years old.<\/jats:p>","DOI":"10.3390\/jcm10040750","type":"journal-article","created":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T02:08:12Z","timestamp":1613268492000},"page":"750","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Skeletal Changes in Growing Cleft Patients with Class III Malocclusion Treated with Bone Anchored Maxillary Protraction\u2014A 3.5-Year Follow-Up"],"prefix":"10.3390","volume":"10","author":[{"given":"Ralph M.","family":"Steegman","sequence":"first","affiliation":[{"name":"Department of Orthodontics, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemarlien Faye","family":"Klein Meulekamp","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjan","family":"Dieters","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Jansma","sequence":"additional","affiliation":[{"name":"Department of Oral Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wicher J.","family":"van der Meer","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2374-1771","authenticated-orcid":false,"given":"Yijin","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, W.J. Kolff Institute, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1177\/1055665618774024","article-title":"Evaluation of Nasal Airway Volume of Operated Unilateral Cleft Lip and Palate Patients Compared with Skeletal Class III Individuals","volume":"56","author":"Ataol","year":"2019","journal-title":"Cleft Palate-Craniofacial J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1597\/05-080","article-title":"Self-Reports of Psychosocial Functioning among Children and Young Adults with Cleft Lip and Palate","volume":"43","author":"Hunt","year":"2006","journal-title":"Cleft Palate-Craniofacial J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1097\/MLG.0b013e318158195e","article-title":"Sleep Disordered Breathing and Obstructive Sleep Apnea in the Cleft Population","volume":"118","author":"Muntz","year":"2008","journal-title":"Laryngoscope"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1016\/j.bjps.2014.07.026","article-title":"Screening for obstructive sleep apnea in children with syndromic cleft lip and\/or palate","volume":"67","author":"Silvestre","year":"2014","journal-title":"J. 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